系统性骨质疏松症和骨质疏松症在全关节整形术后的周围假肢骨折中
Michael W Seward1, Charles P Hannon1, Brandon J Yuan1
1Department of Orthopedic Surgery, Mayo Clinic, Rochester, Minnesota.
The Journal of arthroplasty
|June 9, 2024
概括
大多数关节置换骨折都是脆弱性骨折,表明骨质疏松症. 然而,在这些伤害发生后,诊断,查和治疗的差距仍然存在,需要采取系统的方法来改善患者的治疗结果.
科学领域:
- 整形外科手术 整形外科手术
- 老年医学 老年医学
- 骨的新陈代谢 骨的新陈代谢
背景情况:
- 在全关节整形术 (THA) 后的周围假肢骨折通常是脆弱性骨折,暗示潜在的骨质疏松症.
- 许多患有这些骨折的患者在受伤之前可能有未被诊断或未得到充分治疗的骨质疏松症.
研究的目的:
- 为了评估诊断,查和治疗骨质疏松症的患者在THA后周围假肢大腿骨骨折.
- 为了确定这些脆弱性骨折后的护理缺口.
主要方法:
- 对171个温哥华B2/B3周围假肢大腿骨折进行了回顾性队列研究,这些骨折使用了模块化纹形茎 (2000-2018) 进行治疗.
- 评估骨质疏松症/骨质疏松症诊断的患病率,FRAX评分,骨矿物密度 (BMD) 测试,内分泌咨询和骨折前后的骨质疏松症药物.
- 在推查年龄的1年内定义适合年龄的BMD测试.
主要成果:
- 骨质疏松症的诊断从骨折后的20%增加到39%;骨质疏松症从13%增加到24%.
- 骨折前没有记录FRAX得分;骨折后只有2%. 只有16%的患者接受了适合年龄的BMD测试.
- 骨折后内分泌咨询从6%增加到25%,双酸盐使用从19%增加到25%.
结论:
- 在诊断,查,内分泌学随访和骨质疏松症治疗中存在显著的差距. 在THA后患有周围假肢骨折的患者中.
- 一种系统的方法,类似于非关节塑性骨折的脆弱性骨折,对于管理这些患者至关重要.
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